Monday, May 25, 2009

The Depression Test By screening all teens, doctors hop to identify those with mental disorders

Soon after her sister committed suicide, Caroline Downing started doing poorly at school. During math tests she would freeze up, and she found her mind wandering constantly. Officials at St. Andrew's Episcopal School in Potomac gently suggested that the high school sophomore get a mental health screening.

The idea of a psychiatric evaluation sent chills down the spine of Caroline's mother, Mathy Milling Downing, who believed that her younger daughter, Candace, had committed suicide because of an adverse reaction linked to a psychiatric drug -- the antidepressant Zoloft. Shortly after Candace's death, the Food and Drug Administration placed black-box warnings on several antidepressants to say they elevated suicidal thinking among some children. If Caroline were going to get the same kind of mental health care as Candace, Downing wanted no part of it.

Downing's family offers a powerful case study into the pros and cons of new guidelines recommending widespread screening of adolescents for mental disorders: Last month, the U.S. Preventive Services Task Force, a federal group that makes public health recommendations, said that all adolescents between ages 12 and 18 should be screened for major depression. In March, the Institute of Medicine, which advises Congress on scientific matters, told policymakers that early screening was key to reducing the financial and medical burden of mental disorders in the United States.